妇科腹腔内出血的临床鉴别诊断

Clinical differential diagnosis of gynecological intra-abdominal hemorrhage

目的 明确妇科腹腔内出血的临床特征 ,以减少误诊。方法 对我院 1999年 1月至 2 0 0 1年 12月以妇科腹腔内出血收治的 186例患者的临床资料进行回顾性分析。结果 186例病人包括 5种疾病 ,其中异位妊娠、卵巢破裂、出血性输卵管炎及腹部卒中易相互误诊。本资料 15 0例经手术止血 ,36例经保守治疗成功 ,无 1例死亡。结论 详细询问病史 ,血HCG检测和阴道B超检查 ,后穹窿或腹腔穿刺是简便而重要的诊断手段。

Objective\ To define the clinical manifestation of gynecological intra abdominal hemorrhage in order to reduce misdiagnosis.Methods\ 186 cases diagnosed as gynecological intra abdominal hemorrhage in our hospital from January 1999 to December 2001 were retrospectively analysed.Results\ Five diseases were included in 186 cases,ectopic pregnancy,rupture of corpus lutewn,hemorrhagic salping and abdominal apoplexy,which were easily to be confused with each other.The 150 cases were surgically treated and the 36 cases were conservatively treated.None died. Conclusion\ To make a correct diagnosis ,knowing the history of illness,detecting blood HCG level,having transvaginal ultrasonography examination and having culdocentesis or abdominal paracentesis are important and convenient as well.